Nakagawa T, Tanouchi J, Nishino M, Ito T, Ohnishi S, Tanahashi H, Yamada Y, Abe H
Division of Cardiology, Osaka Rosai Hospital, Japan.
Angiology. 1995 Jun;46(6):531-5. doi: 10.1177/000331979504600612.
A fifty-six-year-old woman was admitted to Osaka Rosai hospital because of dyspnea, chills, and fatigue. The patient was diagnosed by transthoracic echocardiography as having congestive heart failure due to severe biatrioventricular valve regurgitation, and cardiac surgery was proposed. Preoperative transesophageal echocardiography (TEE) revealed a dilatation of the coronary sinus (CS), a right-sided hemiazygos vein (R-AZ), and another great vessel lying between the CS and the R-AZ. Magnetic resonance imaging (MRI) was also performed, and this showed a persistent right superior vena cava (PRSVC) entering the left atrium via the dilatated CS. However, the site of connection between the R-AZ and the PRSVC could not be detected by MRI because of inadequate slice acquisition. Each method has its limitations, particularly with regard to visualizing the extracardiac vascular system. Therefore, the authors demonstrated that the combination of TEE and MRI might be more useful than each alone, and the combination is as a valuable method as digital subtraction angiography for the diagnosis of extracardiac venous anomalies.
一名56岁女性因呼吸困难、寒战和疲劳入住大阪罗赛医院。经胸超声心动图诊断该患者因严重双房室瓣反流导致充血性心力衰竭，并建议进行心脏手术。术前经食管超声心动图（TEE）显示冠状窦（CS）扩张、右侧半奇静脉（R-AZ）以及位于CS和R-AZ之间的另一大血管。还进行了磁共振成像（MRI），结果显示持续存在的右上腔静脉（PRSVC）通过扩张的CS进入左心房。然而，由于切片采集不足，MRI未能检测到R-AZ与PRSVC之间的连接部位。每种方法都有其局限性，尤其是在显示心外血管系统方面。因此，作者证明TEE和MRI联合使用可能比单独使用每种方法更有用，并且这种联合作为一种有价值的方法，与数字减影血管造影术在诊断心外静脉异常方面具有同等价值。
